A5058678950- Sepsis Diagnosis and Treatment
- Emergency and Acute Care Studies
- Heart Failure Treatment and Management
- Electronic Health Records Systems
- Machine Learning in Healthcare
- Respiratory Support and Mechanisms
- Neonatal Respiratory Health Research
- Hemodynamic Monitoring and Therapy
- Medical Coding and Health Information
- Chronic Disease Management Strategies
- Geriatric Care and Nursing Homes
- Cardiac Arrest and Resuscitation
- Healthcare Systems and Technology
- Airway Management and Intubation Techniques
- Cardiac, Anesthesia and Surgical Outcomes
- Energy and Environment Impacts
- Cardiovascular Effects of Exercise
- Tracheal and airway disorders
- Biomedical Text Mining and Ontologies
- Medical Imaging and Pathology Studies
- Health Systems, Economic Evaluations, Quality of Life
- Pulmonary Hypertension Research and Treatments
- Heart Rate Variability and Autonomic Control
- Inhalation and Respiratory Drug Delivery
- Congenital Diaphragmatic Hernia Studies
Harborview Medical Center
2008-2020
University of Washington
2008-2020
Seattle University
2020
McGill University
2013
General Department of Preventive Medicine
2012
University of North Carolina at Chapel Hill
2004
Stanford University
1966-1970
Palo Alto Institute
1968
John A. Hartford Foundation
1965-1967
Stanford Medicine
1965
Now in its Fifth Edition, Clinical Epidemiology: The Essentials is a comprehensive, concise, and clinically oriented introduction to the subject of epidemiology. Written by expert educators, this text introduces students principles evidence-based medicine that will help them develop apply methods clinical observation order form accurate conclusions. Edition includes more complete coverage systematic reviews knowledge management, as well other key topics such abnormality, diagnosis, frequency...
Readmission penalties have catalyzed efforts to improve care transitions, but few programs incorporated viewpoints of patients and health professionals determine readmission preventability or prioritize opportunities for improvement.To readmissions use these estimates areas improvement.An observational study was conducted 1000 general medicine readmitted within 30 days discharge 12 US academic medical centers between April 1, 2012, March 31, 2013. We surveyed physicians, reviewed...
Objectives We validate a machine learning-based sepsis-prediction algorithm ( InSight ) for the detection and prediction of three sepsis-related gold standards, using only six vital signs. evaluate robustness to missing data, customisation site-specific data transfer learning generalisability new settings. Design A machine-learning with gradient tree boosting. Features were created from combinations sign measurements their changes over time. Setting mixed-ward retrospective dataset...
<h3>Importance</h3> Identification of patients at a high risk potentially avoidable readmission allows hospitals to efficiently direct additional care transitions services the most likely benefit. <h3>Objective</h3> To externally validate HOSPITAL score in an international multicenter study assess its generalizability. <h3>Design, Setting, and Participants</h3> International retrospective cohort 117 065 adult consecutively discharged alive from medical department 9 large across 4 different...
Summary Background: Interruptive drug interaction alerts may reduce adverse events and are required for Stage I Meaningful Use attestation. For the last decade override rates have been very high. Despite their widespread use in commercial EHR systems, previously described interventions to improve alert frequency acceptance not well studied. Objectives: (1) To measure of inpatient medication within a clinical decision support system, assess impact local customization efforts. (2) compare...
Many experts believe that hospitals with more frequent readmissions provide lower-quality care, but little is known about how the preventability of might change over postdischarge time frame.
Background Sepsis is a global healthcare challenge and reliable tools are needed to identify patients stratify their risk. Here we compare the prognostic accuracy of sepsis-related organ failure assessment (SOFA), quick SOFA (qSOFA), systemic inflammatory response syndrome (SIRS), national early warning system (NEWS) scores for hospital mortality other outcomes amongst with suspected infection at an academic public hospital. Measurements main results 10,981 adult hospitalized U.S. between...
UW Medicine teaching hospitals have seen a move from paper to electronic physician inpatient notes, after improving the availability of workstations, and wireless laptops technical infrastructure supporting medical record (EMR). The primary driver for transition was unify all disciplines in one location. main barrier faced time required enter which addressed with data-rich templates tailored rounding workflow, simplified login other measures. After 2-year transition, nearly notes...
Dwell time, the time a transit vehicle spends stopped to serve passengers, contributes total reliability of service. is affected by factors such as passenger activity, bus crowding, fare collection method, driver experience, and day. The types effects crowding can have on dwell are debatable because its interaction with activity inaccuracies in calculation. Different payment methods also an effect time. This debate be linked absence appropriate data that actually capture real these...
Algorithm-based clinical decision support (CDS) systems associate patient-derived health data with outcomes of interest, such as in-hospital mortality. However, the quality associations often depends on availability site-specific training data. Without sufficient quantities data, underlying statistical apparatus cannot differentiate useful patterns from noise and, a result, may underperform. This initial burden limits widespread, out-of-the-box, use machine learning-based risk scoring...
New tools to accurately identify potentially preventable 30-day readmissions are needed. The HOSPITAL score has been internationally validated for medical inpatients, but its performance in select conditions targeted by the Hospital Readmission Reduction Program (HRRP) is unknown.Retrospective cohort study.Six geographically diverse centers.All consecutive adult patients discharged alive 2011 with 1 of 4 HRRP (acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, and...
To compare different definitions of multimorbidity to identify patients with higher health care resource utilization.We used a multinational retrospective cohort including 147,806 medical inpatients discharged from 11 hospitals in 3 countries (United States, Switzerland, and Israel) between January 1, 2010, December 31, 2011. We compared the area under receiver operating characteristic curve (AUC) 8 multimorbidity, based on International Classification Diseases codes defining conditions,...
Multimorbidity is associated with higher healthcare utilization; however, data exploring its association readmission are scarce. We aimed to investigate which most important patterns of multimorbidity 30-day readmission. used a multinational retrospective cohort 126,828 medical inpatients defined as ≥2 chronic diseases. The primary and secondary outcomes were potentially avoidable (PAR) all-cause (ACR), respectively. Only diseases included in the analyses. presented OR for according number...
Healthcare organizations vary in the number of electronic medical record (EMR) systems they use. Some use a single EMR for nearly all care provide, while others EMRs from more than one vendor. These strategies create mixture advantages, risks and costs. Based on our experience two over decade, we analyzed within health to identify costs that presents. We identified data functionality types pose greatest challenge patient safety efficiency. present model classify patterns healthcare...
The aim of this study was to identify the combinations chronic comorbidities associated with length stay (LOS) among multimorbid medical inpatients.Multinational retrospective cohort 126,828 inpatients multimorbidity, defined as ≥2 diseases (data collection: 2010-2011). We categorized into using Clinical Classification Software. described 20 strongest association prolonged LOS, longer than or equal country-specific and reported difference in median LOS for those combinations. also assessed...
The HOSPITAL score has been widely validated and accurately identifies high-risk patients who may mostly benefit from transition care interventions. Although this is easy to use, it the potential be simplified without impacting its performance. We aimed validate a version of for predicting likely readmitted.Retrospective study in 9 large hospitals across 4 countries, January through December 2011.We included all consecutively discharged medical patients. excluded died before discharge or...
In order to evaluate mortality predictions based on boosted trees, this retrospective study uses electronic medical record data from three academic health centers for inpatients 18 years or older with at least one observation of each vital sign. Predictions were made 12, 24, and 48 hours before death. Models fit training institution evaluated using hold-out test the same institution, other institutions. Gradient-boosted trees (GBT) compared regularized logistic regression (LR) predictions,...
Fletcher, Grant M.D.; Pender, John W. Wood, Earl H. M.D., Ph.D. Author Information